Angiotomography in the vascular assessment of the recipient before renal transplantation: Literature review

Abstract

Arterial calcification and atherosclerotic lesions, which have a high incidence in chronic renal patients are important risk factors for immediate and late postoperative complications after renal transplantation. Computed tomography angiography of the iliac arteries can accurately show arterial diseases, including the location and extent of arterial calcification, as well as arterial caliber, which would allow better surgical planning of the site of renal implantation. Purpose: This literature review aimed to verify the value of this exam as a diagnostic method for arterial atheromatous disease in the iliac vessels region in patients who are candidates for renal replacement therapy by analyzing primary studies of patients submitted to this exam. Methods: The methodology used was a literary search in electronic databases (PubMed, LILACS, Google Scholar and Cochrane Library), dating from 2003 to 2018. Results: The literature search resulted in a total of 100 articles, 29 of which pre-selected based on title and abstract, and of those, only 6 met the inclusion criteria. CTA allowed high accuracy in the diagnosis of calcification, with sensitivity ranging from 71% to 100%, and specificity ranging from 73% to 92%. Computed tomography angiography was used for surgical planning based on the degree of calcification, and showed that there were anastomosis site changes or vascular procedures before transplantation in 25.2%, cancellation of transplantation due to the degree of arterial calcification in 7,6%, graft loss in 6.8% and death in 3.9% of the cases. Conclusion: Computed tomography angiography has a significant value in detecting vascular calcifications, allowing better surgical planning.